Credit Card Interbank Giro (PDF) - Maybank

Interbank GIRO FormMAYBANKCARDS & UNSECURED LENDINGROBINSON ROAD P.O. BOX 307SINGAPORE 900607BUSINESS REPLY SERVICEPERMIT NO. 08243Interbank GIRO makespayment more convenientHumanisingFinancial ServicesAcross Asia.

MAYBANK CARD INTERBANK GIRO FORM(For payment to Maybank Credit Cards)Pay your Maybank Credit Card bills through Interbank GIROand you no longer need to worry about missing your payment.Sign up today to enjoy the convenience!My/Our Account No. with Financial Institution(1)(2)INSTRUCTIONS1. Signature must be the same as per your Bank's records.2. Please continue to pay your bills by cheque or cash until you receiveconfirmation from us.3. Please allow at least 4 weeks for application to be approved.4. Please use a separate Maybank Card Interbank GIRO Form for eachMaybank Card Account.PART 1: FOR APPLICANT’S COMPLETION (Principal Account Only)Name of Billing OrganisationMaybank, Cards and Unsecured LendingTo: Name of Financial InstitutionMy/Our Company Stamp(s)/Signature(s)/Thumbprint(s) # Date(As in Financial Institution’s records)PART 2: FOR BILLING ORGANISATION’S COMPLETIONBank Branch Billing Organisation’s Account No.7 3 0 2 0 0 1 0 4 0 1 0 6 4 6 8 8 5Bank Branch Account No. To Be DebitedMaybank Credit Card No.– – –BranchPART 3: FOR FINANCIAL INSTITUTION’S COMPLETIONTo Billing OrganisationCardmember’s NameBank Branch Account No. To Be DebitedMaybank Credit Card No.– – –Please indicate your payment instruction below. If you wish to change thisinstruction for a particular month, you should call us at least 5 working daysbefore the payment due date to stop the GIRO instruction:For Credit Card GIRO payment Full Minimum(a) I/We hereby instruct you to process Maybank’s instructions to debit my/our accountbelow as instructed here and/or debit such sum(s) as Maybank may notify you from timeto time.(b) You are entitled to reject Maybank’s debit instructions if my/our account does not havesufficient funds and charge me/us a fee for this. You may also at your discretion allow thedebit even if this results in an overdraft on the account and impose charges accordingly.(c) This authorisation will remain in force until revoked by me/us by written notice deliveredto you. You may at your absolute discretion terminate the above arrangement by writtennotice to me/us delivered to my/our last known recorded address.This Application is APPROVEDThis Application is REJECTED for the following reason(s) * :*Please tick below where appropriateSignature/Thumbprint # differs from Financial Institution’s RecordsSignature/Thumbprint # incomplete/unclear #Account operated by Signature/Thumbprint #Wrong Account NumberAmendments not countersigned by customerOthersMy/Our Name(s) as in Financial Institution’s RecordsMy/Our Contact No.(1) (1)(2) (2)Name of Approving Officer Authorised Signature Date#Please delete where applicable. For thumbprints, please visit our Branches with your identification.Malayan Banking Berhad (incorporated in Malaysia)CUL737/OCT13/AF1/A